Perinatal Mortality among Cohorts of Pregnant Women in three Districts of North Shewa (Degem,Kuyu and Wore Jarso)Oromia Region: Magnitude, Causes and Determinants.
No Thumbnail Available
Date
2013-01
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Ababa University
Abstract
Background: Improving perinatal health is key in decreasing child and infant mortality rates but information on perinatal deaths is highly susceptible to omission and misreporting. Hence community based data can provide more representative and reliable information.
Objective: this Study is intended to assess the magnitude, determinants and main cause of perinatal mortality among babies born from cohorts of pregnant women in three selected districts of North Shewa zone Oromia
Regional State namely Degem, Kuyu and Warajarso.
Methods: A cohort of 5,784 pregnant women were followed through delivery by the Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) from March 2011 to February 2012 in three districts of North Shewa zone of Oromia Regional State where MaNHEP is providing maternal and neonatal health intervention. At the beginning of the study, pregnancy outcomes of 3,916 women were identified by house to house visit using the initial records of MaNHEP in each kebele. Using this cohort we conducted community
based nested case-control design among 67 cases and 134 controls. All perinatal deaths reported between March 2011 to February 2012 were included in the study and two live birth controls born from mothers in
the cohort were included for each perinatal death after a random selection from the same Gote with the cases. A standard verbal autopsy instrument was used as a main data collection tool after adapting to the local
situation. Data were entered using Epi Info version 3.5.1 for windows and exported to SPSS version 20.0 for analysis.Logistic regression model was employed with Crude and Adjusted Odds Ratio at 95 CI, p-value 0.05
taken as level of statistical significance.The probable causes of deaths were assigned by two pediatricians using ICD 10. Principal component analysis was used to construct household socio-economic status of the study participants.
Result: Data were collected from 67 cases and 134 controls. Twenty four (30.38 %) of the cases were still births while 43(54.43%) were early neonatal deaths. The overall perinatal mortality rate in the study area was
19.5 per 1000 live births and still birth. Maternal age greater than 30 years [AOR 2.665, (95% CI:1.0266.922)], having previous history of neonatal mortality [AOR 6.833, (95% CI:2.782-16.782)], preterm births [AOR 6.929,( 95% CI:1.779-26.994)], male sex [AOR 4.049,(95% CI:1.836-8.926)] and home delivery [AOR 3.704,(95% CI:1.192-11.506)] were significantly associated with perinatal mortality in the final model. Birth asphyxia (31%), sepsis (25%), chorioamnionitis (11%), antepartum hemorrhage (9%) were the four leading causes of perinatal death.
Conclusion: The study reported lower perinatal mortality rate than other studies conducted in the country.Majority of the deaths occurred in the first twenty four hours suggesting that interventions should focus on this critical time of vulnerability to save lives of newborn.Potential determinants and causes of perinatal mortality identified in this study were related with maternal factors implies that still there is a need to focus on these major causes of deaths for further intervention.
Description
Keywords
Perinatal Mortality